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Senoir 21-2 > Glaucoma > Flashcards

Glaucoma Flashcards

1
Q

What NML IOP

A

10-21

Higher in the AM compared to PM

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2
Q

Aqueos humor is produced where?

A

Ciliary body

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3
Q

What are the two things you need to Dx glaucoma

A

optic nerve damage AND! visual field loss

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4
Q

What is the anatomical blind spot?

A

Optic disk

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5
Q

What are the two methods of doing a tonometry for glaucoma

A

-Non-contact = air puff

-Applanation = pressing on cornea with instrument
—Tonopen
!!Goldmann applanation = gold standard!!!

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6
Q

What is the gold standard to eval a tonometry

A

Goldman applanation

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7
Q

What is the only thing we can actually treat in glaucoma pts

A

IOP

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8
Q

If a pt has an IOP greater than 21, with a NML optic nerve, ant. Chamber, and no visual field loss

What is the approach

A

No Tx necessary, monitor annually

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9
Q

What are the RSK fx for developing glaucoma

A

Age

Large C/D ration

Thin central corneal thickness

Fm Hx

High Myopia

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10
Q

What is the patho phys of Primary open angle glaucoma

A

Loss of retinal nerve fiber layer (NFL) reduces vision

IOP greater than 28

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11
Q

A pt presents with a cc of tunnel vision

Think

A

Primary open angle glaucoma

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12
Q

What is the treatment approach to primary open angle glaucoma >?

A

Referal to ophthalmology/ optometry

And Rx that decrease the aqueous or increase the flow

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13
Q

What are the rx for primary open angle that decrease the production of aqueous

A

B-blockers

Alpha -2 adrenergics
(Brimonidine or apraclonidine)

Carbonic anhydrase inhibitors
(Dorso lamine, Brinzolamide, Acetazolamide)

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14
Q

What are the Rx for Primary open angle that increase the flow of aqueous

A

Sympathomimietics
(EPI, memantine)

Prostaglandin analogs
(-Prost)

Miotic agents
(Pilocarpine)

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15
Q

What are the ADE of using Alpha 2-adrenergics in POAG

A

Allergic conjunctivitis

Or contact dermatitis

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16
Q

What are the ADE of using prostaglandin analogs in POAG

A

Conjunctival Hyperemia

17
Q

What are the surgical options for POAG that worsens or can be used early on in young pts

A

Argon Laser (plasty)

Or -ectomy (shunt)

Or ciliary body ablation

18
Q

What is the IOP for normal tension glaucoma

A

Less than or equal to 21

19
Q

What kind of glaucoma is associated with OSA

A

Normal tension

Due to decreased ocular perfusion

20
Q

What are the manifestations of acute angle closure

A

Vision may be blurred
Typically unilateral

With monocular halos around lights

Frontal Headcahe with N/V

IOP of 60-80

21
Q

A pt walks into the movie theater and has intense ocular eye pain with photophobia and a frontal headache

Unilateral blurred vision with a mid dilated pupil and shallow anterior chamber

Think

A

Acute Angel closure

More common in women,

22
Q

What is the tx of choice for acute angle closure

A

Láser Iridotomy

23
Q

Peripheral anterior synechiae are the pathology of what type of glaucoma

A

Chronic angle closure

PAS – front of iris binding to corneal endothelium

24
Q

What are the S/s of Chronic angle closure

A

Intermittent eye pain, HA, and blurry vision

25
Q

What is the tx approach to chronic angle closure

A

Trabeculectomy or tube shunt

  • Areas of the angle not involved by PAS
  • Prevent further synechial closure

Goniosynechialysis
-Designed to physically strip PAS

26
Q

What etiology is associated with congenital glaucoma

A

Sturge-Weber syndrome (port-wine stain)

27
Q

A child presents with a corneal diameter greater than 12 mm before age 1

Think

A

Congenital glaucoma

28
Q

What id descemets membrane

A

Linear tears In the cornea seen in congenital glaucoma

Also may see haab striae (horizontal)

29
Q

A 14mm cornea =

A

Megalocornea

30
Q

What is the tx for congenital glaucoma

A

Oral acetazolmide

Topical B-blocks
(Timolol)

SRGY- Goniotomy
Or shunt

31
Q

What is the tx for neovascular glaucoma

A

Timolol

Glaucoma filtration SRGRY
PRP

32
Q

Should you give IOP lowering medication for steroid responce gluacoma ?

A

NO!

Just decrease or d/c steroid use

Senoir 21-2 (77 decks)

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